Under National Health Insurance, Health Care Dollars Are
Allocated So That They Have The Greatest Impact On Health.

Of
all the characteristics of foreign health care systems, the one that strikes
American observers as the most bizarre is the way in which limited resources are
allocated among competing needs. Foreign governments do not merely deny
lifesaving medical technology to patients under national insurance schemes.

They
also take millions of dollars that could be spent to save lives and cure
diseases, and spend them to provide services to people who are not seriously
ill. Often, these services have little if anything to do with health care.

Britain, once again, exemplifies this behavior. Throughout the National HealthService, there is a
pervasive tendency to divert funds from expensive care for the small number who
are seriously ill toward the large number who seek relatively inexpensive
services for minor ills. Take the British ambulance service, for example:
[138]

English "patients" take more than 2l million ambulance rides each year – about
one ride for every two people in England.

About 91 percent of these rides are for nonemergency purposes (such as taking an
elderly person to a local pharmacy) and amount to what an official task force
report described as little more than "free taxi service."

Yet for genuine emergencies, the typical British ambulance lacks the modern,
lifesaving equipment considered standard in American cities.

While as many as 9,000
people die each year from lack of treatment for kidney failure, the NHS provides
an array of comforts for the many chronically ill people whose kidneys are in
good working order:

Each year about 4.1 million people in England are treated in their homes by
"health visitors " – more than 1.1 million are treated in their homes by
chiropodists and "meals on wheels" serves almost 33 million meals in people's
homes.

Social workers attending to the needs of the elderly and the handicapped help
with the installation of more than 17,000 telephones and telephone attachments,
help arrange more than 93,000 telephone rentals, help more than 49,000 people
with home alterations, assist in arrangements for 63,000 vacations and help an
additional 346,000 people with other personal appliances and aids.

While tens of thousands
of people classified by their physicians as being in "urgent need" of
surgery wait for hospital beds, the NHS spends millions on items that have only
marginal effects on health:

On the average, the NHS spends more than $90 million each year on tranquilizers,
sedatives and sleeping pills, almost $32 million on antacids and about $11
million on cough medicine.

About 9.7 million people receive "free" eyesight tests every year, and of these
about 2.3 million receive free or subsidized eyeglasses.
[139]

If the NHS did nothing
more than charge patients the full costs of their sleeping pills and
tranquilizers, enough money would be freed to treat 10,000 to 15,000 additional
cancer patients each year and save the lives of an additional 3,000 kidney
patients. Yet such options are not seriously considered.

A
full description of the ways in which "caring" takes priority over "curing"
within the British National Health Service would fill a volume the size of a
phone book, and readers may wish to consult other references.
[140] Suffice it
here to say that the tendency pervades every aspect of British medicine.

Spending Priorities in Canada.

Although not as pronounced, similar trends can be observed in Canada, where the
government has expanded the services of general practitioners while tightly
controlling access to modern medical technology. For example:
[141]

In the United States, only 13 percent of all
physicians are engaged in general practice or family practice.

In Canada, over half of all physicians are general practitioners and the
percentage of GPs has been rising over the past two decades.

Ontario even has a
policy requiring that 55 percent of its physicians be in general practice.

In general, Canadians have
little trouble seeing a GP. But specialist services and sophisticated equipment
are increasingly rationed. As noted above, although the United States has seen a
major expansion of outpatient surgery, Canada has actively discouraged this
trend – presumably to control spending. All over Canada, CAT scanners and other
equipment are restricted to hospitals, and Ontario has legislated this
restriction.[142] The Canadian system
encourages the provision of routine services for the many at the expense of
specialized care for the few. As one Canadian economist observed, "A growing
number of operations are triaged because resources are used to continue
first-dollar coverage for sniffles and splinters."
[143]